Outcomes of 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis

Hsu, Chia-Ming; Chen, Shih-Chou; Wu, Tsung-Tien; Sheu, Shwu‐Jiuan

doi:10.1016/j.jcma.2017.05.001

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Pediatric posttraumatic endophthalmitis with initial NLP occurs in 9.9% of patients. After management with vitreoretinal surgery, 5.3–15% of eyes with endophthalmitis have a final visual outcome of NLP [22, 23]. In this study, endophthalmitis is detected in 22.66% (196/865) of eyes with POGI, and 11.73% (23/196, not shown in the results) of these eyes suffer from a visual prognosis of NLP after vitreoretinal surgery with or without silicone oil tamponade.…”

Section: Discussionmentioning

confidence: 53%

Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception

Xing

Yuan

et al. 2020

Ophthalmologica

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Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p＜0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p＜0.001) and anatomic success (OR=4.515, p＜0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.

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Section: Discussionmentioning

confidence: 53%

Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception

Xing

Yuan

et al. 2020

Ophthalmologica

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“…Since 1980, the success rate of PPV, defined as a final vision of 20/400 or better, has increasingly improved ranging from 42 to 73%. Therefore, complete PPV is now recommended the "gold standard" treatment of endophthalmitis [13,18]. In our study, severe vitritis accounted for 91.6% of the cases, which showed a worse final vision of 0.76 (SE, 35/200) logMAR than those in the group of mild to moderate vitritis with a significant difference.…”

Section: Discussionmentioning

confidence: 56%

Treatment outcomes of acute postoperative infectious endophthalmitis

et al. 2021

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Background Acute postoperative endophthalmitis is one of the most severe complications of modern ophthalmic procedures including cataract surgeries, vitrectomy and intravitreal injection (IVI). We evaluated the treatment outcomes of acute postoperative infectious endophthalmitis. Methods In this retrospective study, we collected data from 82 patients with acute infectious endophthalmitis within 6 weeks after intraocular surgeries, including cataract surgeries, vitreoretinal surgeries, and IVI, from January 2010 to December 2019. We analyzed the pre-treatment, treatment-related and post-treatment factors that affected visual outcomes. Results The mean age was 67.65 ± 9.52 years, the proportion of male patients was 56.1%. The mean baseline vision was 1.92 (Snellen Equivalent SE], counting finger [CF]) ± 0.54 logarithm of the minimum angle of resolution (log MAR) and the mean final vision was 0.71 (SE, 39/200) ± 0.80 logMAR. Visual improvement was significant (P < 0.001). The pre-treatment factors affecting final visual outcomes were diabetes, hemodialysis, baseline vision, signs of vitreous opacity, and different surgeries before endophthalmitis; the treatment-related factors affecting visual outcomes were the choice factors between IVI of antibiotics alone and vitrectomy combined with IVI of antibiotics, and the injection numbers of antibiotics; post-treatment factors affecting visual outcomes were complications such as retinal detachment (RD), glaucoma and macular pucker. Furthermore, prior cataract surgery was associated with a better mean final vision of 0.57 (SE, 54/200) ± 0.67 logMAR while prior vitrectomy resulted in the worst mean final vision of 1.38 (SE, 21/500) ± 0.75 logMAR. Conclusions The important factors that affected the final visual prognosis, included diabetes, hemodialysis, baseline vision, severity of vitritis, treatment strategies and complications. The treatment outcomes revealed better final vision in prior cataract surgery than vitrectomy.

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“…92 Another study looking at 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis in Taiwan concluded that it was a safe and effective option with good visual outcomes. 96 Reduced wound leakage and hypotony can potentially be achieved by using an oblique incision or multistage incision similar to cataract surgery. 97,98 The use of even smaller instrumentation has shown positive results in multiple retrospective studies.…”

Section: Pars Plana Vitrectomymentioning

confidence: 99%

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

Keffer

Chin

Almeida³

2018

Journal of VitreoRetinal Diseases

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The purpose of this review is to provide an update on etiologies, preventive practices, management options, and surgical techniques for infectious endophthalmitis. Methods: A literature search was conducted for studies published over the past 5 years. Results: Endophthalmitis continues to be an uncommon but dangerous complication following cataract surgery. Recently, intravitreal injections have become heavily utilized as a treatment for various ocular diseases, leading to a greater incidence of postinjection infections. Likewise, long-term risk of endophthalmitis should always be a consideration following glaucoma surgery and implanted drainage devices. Although significant overlap exists for causative organisms among the different etiologies, more targeted studies are needed to better optimize treatment. There has been a lack of updates to treatment guidelines since the Endophthalmitis Vitrectomy Study was published in 1995. Despite promising outcomes seen with newer surgical techniques, the lack of randomized clinical trials represents a major barrier to widespread implementation of these approaches. Conclusions: Povidone-iodine prophylaxis remains the primary evidence-based technique for decreasing the rates of endophthalmitis following intraocular procedures. Intracameral antibiotics have gained momentum in recent years and represent a step forward in mitigating the risk of infection with cataract surgery, although some debate still exists. Newer surgical techniques for vitrectomy that improve visualization, minimize surgical trauma, and decrease operative time would benefit from large-scale randomized trials.

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Outcomes of 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis

Abstract: 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome.

Cited by 12 publications

References 11 publications

Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception

Risk Factors and Prognosis of Pediatric Open Globe Injuries without Initial Light Perception

Treatment outcomes of acute postoperative infectious endophthalmitis

Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques

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